Rates of attendance at a smoking cessation clinic within a cardiac rehabilitation service

Objectives: Smoking cessation has been shown to be an important intervention for preventing cardiovascular events and improving the health of patients with heart disease. However, unaided quit attempts in these patients often leads to high rates of failure and a return to smoking. Outpatient smoking cessation clinics using face-to-face counseling, ongoing behavioral support, advice on smoking pharmacotherapy and objective monitoring, have been found to be one of the most effective interventions for improving quit smoking rates. An outpatient smoking cessation clinic was trialed within a cardiac rehabilitation service in order to explore its effects on smoking rates for patients with or at risk of heart disease. Attendance rates to the clinic were also monitored. Methods: A descriptive exploratory design was used for this newly developed clinic. Patients who currently smoked tobacco and who had a history of either coronary artery disease, heart failure, atrial fibrillation or those seen under a chest pain assessment service were invited to an outpatient ‘Cardiac Patients Smokers Clinic’. Initially patients were offered up to 10 clinic visits over a 3 month period. Follow-up clinic visits were conducted at 3, 6 and 12 months. A portable carbon monoxide meter was used to objectively measure levels of smoking and validate smoking abstinence. Primary outcomes included rates of attendance. Results: Preliminary findings showed 24 per cent of participants (N = 6) completed all their clinic visits and remained smoke free as measured by their ongoing expired carbon monoxide readings. Clinic attendance rates appeared lowest for those with significant mental health issues such as schizophrenia or substance abuse. However, rates of attendance were improved by having an administration officer make reminder telephone calls prior to clinic visits. Conclusions: Early findings indicate the feasibility of providing a specialist smoking cessation clinic within a cardiac rehabilitation service. Further, that reminder telephone calls prior to appointments improved attendance rates in patients with heart disease to this type of clinic. However, future investigations are warranted.

Multidisciplinary team approach for a peer-support based cardiac-diabetes self-management program

Background: Cardiac patients with diabetes are at higher readmission rates (22%) compared to only 6% for those patients without diabetes. Evidence shows benefits of peer support and using information technology to improve chronic illness and achieve better health outcomes. However limited evidence suggests that cardiac or diabetes self-management programs incorporating peer supporters (patients with similar conditions) or telephone and text-messaging, have improved health outcomes and reduce health care utilisations. A multidisciplinary research team approach is crucial to accommodate the complex aspects of delivering intervention programs for these at-risk patients. However, challenges such as the inconsistency in significance of key concepts across research fields, as well as practical and operational issues within different contexts are often experienced. Aims: To develop an effective multidisciplinary team approach to deliver a peer support based cardiac-diabetes self-management program incorporating the preparation of lay personnel to provide telephone and text-messaging follow up support. Methods: The approach was used for a multidisciplinary project using randomised controlled trial. Results: The findings from multidisciplinary team approach reveal the feasibility of a Peer support based cardiac-diabetes self-management program.

Investing and reinvesting in social capital : the spill-over effects of social capital in self help groups

Part studies on the impact of microfinance through self help groups (HGs) and other collective poverty alleviation initiatives have predominantly focused on the financial benefits to the individual or the group (Hermes and Lensink 2011; Hulme and Mosley 1996). Such benefits are typically attributed to the financial capital made available to SHGs (Swain and Varghese 2009) and the social capital which accrues through networking mechanisms within SHG processes (Tesoriero 2005). Few studies however, have examined the benefits of SHGs beyond group members. Accordingly, research was conducted to look beyond the immediate group processes and outcomes, and examine the impact of SHGs in the wider (local) community.

Evaluating Communication for Development : A Framework for Social Change

Evaluating Communication for Development presents a comprehensive framework for evaluating communication for development (C4D). This framework combines the latest thinking from a number of fields in new ways. It critiques dominant instrumental, accountability-based approaches to development and evaluation and offers an alternative holistic, participatory, mixed methods approach based on systems and complexity thinking and other key concepts. It maintains a focus on power, gender and other differences and social norms. The authors have designed the framework as a way to focus on achieving sustainable social change and to continually improve and develop C4D initiatives. The benefits and rigour of this approach are supported by examples and case studies from a number of action research and evaluation capacity development projects undertaken by the authors over the past fifteen years. Building on current arguments within the fields of C4D and development, the authors reinforce the case for effective communication being a central and vital component of participatory forms of development, something that needs to be appreciated by decision makers. They also consider ways of increasing the effectiveness of evaluation capacity development from grassroots to management level in the development context, an issue of growing importance to improving the quality, effectiveness and utilisation of monitoring and evaluation studies in this field. The book includes a critical review of the key approaches, methodologies and methods that are considered effective for planning evaluation, assessing the outcomes of C4D, and engaging in continuous learning. This rigorous book is of immense theoretical and practical value to students, scholars, and professionals researching or working in development, communication and media, applied anthropology, and evaluation and program planning.

College, shared house, or home? The impact of living situation on university students’ drinking

University students are recognised as a heavy drinking group who are at risk of both short and long term harms from their alcohol consumption. This paper explores the social dynamics of drinking and the key differences between three core groups of university students – those who live at home, those living in college and those who live independently. We draw on a large scale survey of Australian university students on alcohol consumption and harm minimisation and extensive qualitative individual and focus group interviews with university students in Victoria, New South Wales and Queensland. Our data suggests that living at home supports safer drinking in comparison to the less regulated college context or living independently in shared households.

Collaborative governance and innovation in social enterprises

While social enterprises have gained increasing policy attention as vehicles for generating innovative responses to complex social and environmental problems, surprisingly little is known about them. In particular, the social innovation produced by social enterprises (Mulgan, Tucker, Ali, & Sander, 2007) has been presumed rather than demonstrated, and remains under-investigated in the literature. While social enterprises are held to be inherently innovative as they seek to response to social needs (Nicholls, 2010), there has been conjecture that the collaborative governance arrangements typical in social enterprises may be conducive to innovation (Lumpkin, Moss, Gras, Kato, & Amezcua, In press), as members and volunteers provide a source of creative ideas and are unfettered in such thinking by responsibility to deliver organisational outcomes (Hendry, 2004). However this is complicated by the sheer array of governance arrangements which exist in social enterprises, which range from flat participatory democratic structures through to hierarchical arrangements. In continental Europe, there has been a stronger focus on democratic participation as a characteristic of Social Enterprises than, for example, the USA. In response to this gap in knowledge, a research project was undertaken to identify the population of social enterprises in Australia. The size, composition and the social innovations initiated by these enterprises has been reported elsewhere (see Barraket, 2010). The purpose of this paper is to undertake a closer examination of innovation in social enterprises – particularly how the collaborative governance of social enterprises might influence innovation. Given the pre-paradigmatic state of social entrepreneurship research (Nicholls, 2010), and the importance of drawing draw on established theories in order to advance theory (Short, Moss, & Lumpkin, 2009), a number of conceptual steps are needed in order to examine how collaborative governance might influence by social enterprises. In this paper, we commence by advancing a definition as to what a social enterprise is. In light of our focus on the potential role of collaborative governance in social innovation amongst social enterprises, we go on to consider the collaborative forms of governance prevalent in the Third Sector. Then, collaborative innovation is explored. Drawing on this information and our research data, we finally consider how collaborative governance might affect innovation amongst social enterprises.

Ruptures in the heterosexual matrix through teenage flows and multiplicities

This article analyzes a series of stories and artworks that were produced in a collective biography workshop. It explores Judith Butler’s concept of the heterosexual matrix combined with a Deleuzian theoretical framework. The article begins with an overview of Butler’s concept of the heterosexual matrix and her theorizations on how it might be disrupted. It then suggests how a Deleuzian framework offers other tools for analyzing these ruptures at the micro level of girls’ everyday interactions.

The Cyndi Lauper affect : bodies, girlhood and popular culture

Using a collective biography method informed by a Deleuzian theoretical approach (Davies and Gannon 2009, 2012), this article analyses embodied memories of girlhood becomings through affective engagements with resonating images in media and popular culture. In this approach to analysis we move beyond the impasse in some feminist cultural studies where studies of popular culture have been understood through theories of representation and reception that retain a sense of discrete subjectivity and linear effects. In these approaches, analysis focuses respectively on decoding and deciphering images in terms of their normative and ideological baggage, and, particularly with moving images, on psychological readings. Understanding bodies and popular culture through Deleuzian notions of “becoming” and “assemblage” opens possibilities for feminist researchers to consider the ways in which bodies are not separate from images but are, rather, becomings that are known, felt, materialized and mobilized with/through images(Coleman 2008a, 2008b, 2008c, 2009, 2011; Ringrose and Coleman 2013). We tease out the implications of this new approach to media affects through three memories of girls’ engagements with media images, reconceived as moments of embodied being within affective flows of popular culture that might momentarily extend upon ways of being and doing girlhood.

Spontaneous Volunteering During Natural Disasters

The recent spate of natural disasters across Australia has led to an outpouring of spontaneous volunteering, both formally through nonprofit and government agencies and informally through local community and online networks. Relatively little is understood about the motivations and characteristics of spontaneous volunteers. The aims of this project were to:  Examine the characteristics and motivations of spontaneous volunteers who respond to a crisis event;  Illuminate the effects of spontaneous volunteering on personal, social and civic networks;  Explicate the conditions under which sustained volunteering and other forms of civic engagement arise from spontaneous volunteering and;  Consider the practical implications of these findings for organisations involved in coordinating volunteers both with and beyond disaster events.

Developmental lessons from the Capricornia Arts Mob : ‘learning to speak with one voice’

The Capricornia Arts Mob also known as CAM is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton Region. Its members are eclectic and include an 18 year old through to Elders. CAM has already had a major exhibition in Rockhampton and is submitting work to a range of arts festivals, events and exhibitions. While their achievements are steadily growing and they have been meeting for 18 months, they have been reluctant to incorporate or implement a formalised structure. In learning how to work together there have been tensions and struggles, there has also been the exhilaration of working collaboratively as artists from diverse Indigenous cultures who utilise different mediums. This has resulted in an incredible vibrancy in creative praxis. Members will share some of CAM’s learnings of the developmental process to date and thoughts and dreams about the future.

Using participatory action research for heart self care amongst indigenous patients

This paper describes the initial phases of the Fluid Watchers Pacific Rim project: a participatory action research project that involves developing and trialling an iPad app to provide monitoring and self-care for Indigenous Australians with heart failure. The development phase involved working with health experts, an IT team and Indigenous heart-failure patients through three cycles of development and critical reflection. This was followed by a small pilot study to examine the app’s effectiveness. In this paper, the researchers explain why IT-supported health education can be successful in decreasing re-hospitalisation and improving self-management skills. They describe the steps they took to ensure community participation and ownership of the project and present the findings of their pilot study. This pilot project suggests that an iPad app may be a practical and successful way to provide health-care support for Indigenous Australian heart-failure patients.

Using cultural-historical activity theory (CHAT) to study the relationship between school leadership and organisational change

This study aimed to identify how school leaders’ practices influence department activities during school transformation. The method used to explore emerging disturbances and contradictions within and between school departments was based on Cultural Historical Activity Theory (CHAT). The findings show that in order to implement educational changes in schools successfully, leaders should promote the change they envision as being highly consistent with the current collective identity (shared object) of the departments. From this perspective, the systemic components of the school departments are given a sense of preservation and continuity, rather than loss.

The experience of being an advanced practice nurse within Australian acute care settings : a systematic review of qualitative evidence

Background There is a vast amount of international literature which, although agreeing on the need for advanced practice nurse roles, simultaneously debates and discusses the difficulties with nomenclature, definition and subsequent implementation of such roles. Due to this ambiguity it is difficult to equally compare evidence in this field across different countries. A context-specific systematic review on the qualitative evidence of the experience of being an advanced practice nurse in Australia has not been undertaken previously, however it is imperative for nursing managers and leaders to understand the complexities of advanced nursing roles in order to effectively utilise and retain these experienced and valuable nurses. With the creation of a national nursing regulating authority in 2010, it is timely to explore in-depth the experience of being an advanced practice nurse from a national perspective. Objective To identify the experience of being an advanced practice nurse working in Australian acute care settings. Inclusion criteria -Types of participants Registered nurses working in advanced practice roles in acute care settings throughout Australia. -Phenomena of interest The experience of being an advanced practice registered nurse working in an Australian acute care setting, as reported by the nurses themselves. -Types of studies Interpretive qualitative studies including designs such as phenomenology, grounded theory and ethnography. -Search strategy A three step search strategy was used to identify published and unpublished studies. The search process was conducted from August to October 2011 and considered published and unpublished studies from 1990 to October 2011. -Methodological quality Studies were appraised for methodological quality by two independent reviewers using the Joanna Briggs Qualitative Assessment and Review Instrument. -Data extraction Data was extracted from the papers included in the review using the standardised Joanna Briggs Institute Qualitative Assessment and Review Instrument data extraction tool. -Data synthesis Research findings were pooled using the Joanna Briggs Institute Qualitative Data and Review Instrument. Results Three published studies and one unpublished dissertation were included in the review. From these four studies, 216 findings were extracted, forming 18 categories which were then analysed to create six synthesised findings. Six meta-syntheses under the headings of expert knowledge, confidence, education, relationships, negative experiences and patient centred experience were formed from the findings. Conclusions The synthesised findings confirm that the experience of advanced practice nurses in Australian acute care settings is complex and greatly influenced personally and professionally by the organisation as well as the unpredictable nature of working with people.

Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes : a cross cultural international collaborative project

Background The prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan. Methods/design A randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks. Discussion If the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.

Fresh ideas : services thinking for social marketing

Purpose The social marketing literature tends to focus on upstream marketing (policy) and downstream (individual behaviour change) and has a limited view on midstream (working with partners and community groups) social marketing. The paper proposes midstream social marketing should also include an understanding of how services and service employees influence and support individual behaviour change goals. The paper presents four key services marketing principles - derived from services theory and thinking - which the paper believes to be essential for implementing effective midstream social marketing. Design/methodology/approach This is a conceptual paper that uses service theory and case-examples to show how service thinking can be used as a midstream social marketing approach. Findings For effective uptake and impact of social marketing services amongst people and populations, social marketers need to design programs that consider the service experience, the service employee, service quality/customer value and the active role of the customer in value creation. Research limitations/implications Services marketing is a well-established sub-discipline of marketing which, until recently, has not interacted with social marketing. The extension and application of services theory for social marketing can enrich and propel the social marketing discipline forward. Further research is recommended to evaluate how service principles can be applied in practice. Social implications Given that social marketing services tend not to be accessed in sufficient numbers by the people who most need them, social marketers need to think beyond the technical, cognitive, and organisational-focused goals when designing social services. Originality/value This paper identifies key service theories that social marketers should understand and use and is thus a source of fresh ideas for theory and practice.